保留与不保留锁骨上神经对锁骨切口周围皮肤感觉的影响  

Influences on cutaneous sensation around clavicular incision with or without supraclavicular nerve

作　　者：秦庆庆 张超[2] 王雄[2] 王勇平[2] QIN Qingqing;ZHANG Chao;WANG Xiong;WANG Yongping(The First Clinical Medical College of Lanzhou University,Lanzhou 730000,Gansu,China;Department of Orthopaedics,the First Hospital of Lanzhou University,Lanzhou 730000,Gansu,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院骨科,甘肃兰州730000

出　　处：《右江医学》2024年第3期203-207,共5页Chinese Youjiang Medical Journal

基　　金：国家自然科学基金(8196398);甘肃省自然科学基金(20JR5RA369);甘肃省卫生行业科研计划项目(GSWSKY2021-009);兰州大学医学科研创新能力提升计划项目(Lzuyxcx-2022-187)。

摘　　要：目的探讨锁骨骨折切开复位内固定术中保留与不保留锁骨上神经对锁骨切口周围皮肤感觉的影响。方法选择2016年3月至2023年2月采用切开复位钢板内固定治疗锁骨骨折患者60例,男20例、女40例,年龄20~73(40.70±14.57)岁,根据是否保留锁骨上神经分为试验组(保留锁骨上神经)和对照组(不保留锁骨上神经)各30例。试验组术中游离保护锁骨上神经,对照组则不保留此神经。术后1周测定两组患者手术切口周围皮肤触觉、痛觉减退区域的面积,用SPSS 26.0软件统计分析。结果60例患者均获得随访。试验组30例患者中,25例患者的触觉、痛觉完全正常,5例患者有较小范围的感觉障碍;对照组30例患者中,3例患者有较小范围的感觉障碍,其余27例均有大面积的触觉、痛觉缺失。两组触觉及痛觉障碍区域的面积比较差异有统计学意义(P<0.001)。结论锁骨骨折切开复位内固定术中游离保护锁骨上神经可明显降低手术切口周围皮肤感觉障碍,有利于患者术后患侧肩部功能恢复。Objective To explore influences on cutaneous sensation around clavicular incision with or without supraclavicular nerve during open reduction and internal fixation of clavicle fractures.Methods From March 2016 to February 2023,a total of 60 patients,including 20 males and 40 females,aged 20-73(40.70±14.57)years old,were treated with open reduction and plate internal fixation for clavicle fractures.They were randomly divided into experimental group(the supraclavicular nerve was reserved)and control group(the supraclavicular nerve was not reserved),with 30 cases in each group.The supraclavicular nerve was freed and protected in the experimental group,while it was not reserved in the control group.One week after operation,the areas of cutaneous hypesthesia and analgesia around the surgical incision were measured in the two groups,and SPSS 26.0 software was used for statistical analysis.Results 60 patients were followed up.Among 30 patients in the experimental group,the cutaneous tactile and pain sensation of 25 patients were completely normal,while the other 5 patients had a small range of sensory disturbance;among 30 patients in the control group,3 patients had a small range of sensory disorders,while 27 patients all had large areas of missing touch and nociception.There were significant differences in the areas of cutaneous tactile and pain disorder between the two groups(P<0.001).Conclusion Free protection of the supraclavicular nerve during open reduction and internal fixation of clavicle fractures can significantly reduce skin sensory disorders around the surgical incision,which is beneficial for the postoperative recovery of the affected shoulder function in patients.

关 键 词：锁骨骨折 锁骨上神经 感觉障碍 

分 类 号：R683.41[医药卫生—骨科学]